COMMON QUESTIONS ABOUT ACUPUNCTURE & NATUROPATHIC MEDICINE IN IMPROVING FERTILITY

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1 COMMON QUESTIONS ABOUT ACUPUNCTURE & NATUROPATHIC MEDICINE IN IMPROVING FERTILITY How does acupuncture influence the female reproductive system? Acupuncture has been reported to promote the circulation of blood in the pelvic cavity and improve ovarian function. Acupuncture treatment may be beneficial in promoting follicle production, enhancing uterine blood flow and improving uterine lining thickness. How does acupuncture & naturopathic medicine assist in improving the likelihood of pregnancy? There are two main factors that improve the success rate of in vitro fertilization (IVF). First, when the woman is younger, the in IVF success rate is significantly higher. Second, when the woman is healthier, the success rate of IVF is also increased. Acupuncture and naturopathic medicine can be used to improve one's overall health status, thereby positively enhancing the chance of pregnancy. Dr. Misa customizes each patient s fertility program in order to optimize the function of the entire body, especially the reproductive system. If aging negatively affects fertility, does acupuncture and naturopathic medicine reverse the aging process? There is a strong correlation between age and reproductive health. However, it is important to remember that there are two types of aging: chronological and biological. While everyone ages at the same speed chronologically, the biological aging process differs greatly among each individual. That is the reason why each woman goes into menopause at a different time of their lives. So while it is generally true that the quality of a woman's eggs declines as she ages, eggs of some women in their forties can be excellent quality due to slow biological aging. It is not possible to stop chronological aging; however, we can definitely influence the progress of biological aging. Abusive lifestyle factors such as poor diet, smoking, stress, and insufficient sleep all accelerate the cell oxidation and the biological aging process. Practicing a healthy lifestyle with a proper diet and necessary supplements in addition to regular acupuncture treatments will have a positive impact in slowing down the aging process.

2 My FSH is too high. Does acupuncture and naturopathic medicine correct hormonal imbalance? An increasing number of women are visiting acupuncture clinics seeking help in correcting the hormone imbalances (FSH, LH, E2, progesterone, prolactin etc.) they are suffering from. There are a number of botanical supplements that may address hormonal imbalances, including high FSH. Dr. Misa will examine your blood work and prescribe botanical combinations that are right for you. Regular acupuncture treatments can be very helpful in regulating hormonal imbalances, although it should be noted that acupuncture does not directly alter the female hormones. Rather, acupuncture is considered to influence the hormonal regulation centers in the brain and autonomic nervous system (i.e., the hypothalamic-pituitary-ovarian axis) and as a result, improvement in hormonal status can occur over time. As I receive a series of treatments, how do you and I know that acupuncture is working for me? If you are not presently on hormones, we recommend that you record your basal body temperature (BBT) every morning. The BBT chart is not the best method available to detect the exact time of ovulation; however, it is an excellent method to get an idea about the female hormone fluctuation pattern and can be used as one of the indexes to know your progress by observing changes in the BBT pattern from month to month. Dr. Misa also offers urinary ovulation testing to indicate fertile days during the menstrual cycle. As mentioned earlier, the focus of Dr. Misa s acupuncture approach is to help improve overall health. Therefore, as patients receive a series of acupuncture treatments, many of them experience enhanced feelings of well-being such as more restful sleep, better digestion, decreased anxiety, increase in energy, etc. These physical and emotional shifts can only positively influence the chance of conceiving regardless of whether one is trying naturally or undergoing medical reproductive treatment. Will acupuncture hurt? Where are you going to place the needles? Dr. Misa only uses sterile, disposable needles in her practice. All needles are used once then discarded. Acupuncture is performed with the patient comfortably lying down. Most patients feel calm and may even fall asleep during the treatment. The needles are initially tapped to cross the skin barrier, then inserted further to the appropriate depth, approximately 0.5. Some patients don t feel anything at all, while some report an ache, warmth, or tingling sensation. The length of the acupuncture treatment is usually between minutes. The location of acupuncture points will vary from patient to patient and from treatment to treatment. Some of the most well-known acupuncture points, traditionally used to influence the function of the female reproductive organs, are located on the lower back, lower abdomen, and legs. The points on

3 the lower back and lower abdominal regions are particularly important in consideration of female anatomy and the related spinal nerves controlling these organs. The points on head, neck, upper back and arms are used in order to induce the relaxation response. What else besides the acupuncture points determines the effect of the treatment? Naturopathic doctors are not only trained in acupuncture but other modalities such as diet and supplement consultation, botanical medicine, hydrotherapy and homeopathy. The advantage of seeing a naturopathic doctor is that Dr. Misa will incorporate the benefits of all these modalities to help improve your fertility and overall health. It is of importance to note that these modalities are also extremely beneficial in pregnancy and labour. What is moxibustion treatment? What is the purpose of an infrared heat lamp? Moxibustion is a form of heat treatment using a moxa stick that stimulates specific acupuncture points of the body. Moxibustion has been used in combination with acupuncture to treat a variety of diseases for thousands of years. Most women who have difficulty conceiving have symptoms of cold hands and feet even in the summertime and sufficient blood flow to their reproductive organs is often compromised. The heat stimulation applied on selected acupuncture points helps to increase blood circulation to the uterus and pelvic area. The gentle soothing heat provided by moxa also induces a deep relaxation response which aids fertility as well. However, the herbs in the moxa stick have a strong odour when burned, which some patients find unfavourable. Dr. Misa uses an infrared heat lamp which has a similar effect on the body to moxibustion, without the odour. It is a lamp that emits infrared heat and is placed over the patient s abdominal area during the acupuncture treatment. When during my cycle should I get acupuncture done? Should I come just before ovulation? Acupuncture treatments should be done on a regular basis throughout your cycle. You can expect a limited effect by receiving acupuncture only around ovulation time. Compared to many of the fertility drugs which provide a powerful effect for a short duration, the immediate effect of acupuncture treatment is, in general, very subtle. The cumulative effect from regular acupuncture treatments, however, can produce significant long lasting benefits. What if I unknowingly become pregnant while I am receiving acupuncture? Potential risks and benefits of acupuncture vary greatly depending on who does the treatment and when and what kind of acupuncture methods are used. Dr. Misa s acupuncture procedure is designed to be administered during any phase of the menstrual cycle in order to achieve the most optimal cumulative effect and avoids points that are contraindicated during pregnancy.

4 Do you use different types of acupuncture treatments depending on the time of the cycle? While the general principle of the treatment remains the same, each acupuncture session is slightly modified in order to induce more specific effects depending on the time of the cycle. For example, a more specific protocol may be used when applying acupuncture after ovulation, in order to maintain a calm state and in an attempt to support the implantation. Do you provide acupuncture treatments in conjunction with conventional assisted fertility treatments? The advantage of acupuncture is that treatments can be performed on patients at all levels of fertility care from those women just trying get their body healthy in preparation for pregnancy to those who are having IVF. Many patients have been receiving acupuncture at Meridian while undergoing IVF or IUI treatments. We also have patients who have been going through cycle monitoring with or without fertility drugs. I will be undergoing IVF. When should I start acupuncture? While some patients respond to acupuncture quickly, acupuncture certainly does not work overnight. Most patients require a series of ongoing treatments over a few months to a year. The recommended treatment schedule is based on consideration of a variety of factors in each individual case. In many cases, we recommend that you start acupuncture treatment at least 2 months prior to the commencement of the IVF cycle and that you continue for 1 to 2 times a week until the day of the transfer. Is there any research data on acupuncture and infertility? The most well-known study was published in April 2002, in which German researchers reported a success rate by nearly 42.5% in women undergoing in vitro fertilization (IVF) using acupuncture versus 26.3% in those without. This is quite impressive considering that they had administered only two short acupuncture treatments. We definitely have yet to see further replicated studies to confirm their findings and applicability under different settings. In this study, is important to remember that: The sample size is relatively small. Only 80 patients were tested per group. The results obtained by the German group are only applicable to a very limited patient population under very restricted circumstances. The acupuncture was only applied immediately before and after the embryo transfer, which means that there was no influence of acupuncture on the patients' eggs. Quality of eggs is a large factor to consider in fertility and the study only enrolled couples who had good quality embryos.

5 This study was not designed to determine when or how acupuncture would best be administered. It is very unlikely that most patients would obtain consistent results by using only the acupuncture points they listed in the study. Dr. Misa takes into consideration the points used in this study, but also uses other acupuncture points from various texts, case studies of other skilled practitioners, as well as from her own clinical experience. What is your success rate of acupuncture treatment for infertility? Due to the individualized treatments used in Dr. Misa s practice, it is extremely difficult to provide statistics of acupuncture treatment for infertility. This is because each treatment plan focuses on the patient s whole body, not just infertility, since all the organ systems function as one unit. Each patient is unique with different health concerns and health histories. Because no two cases are alike, success rates in a naturopathic practice cannot be appropriately compared to provide statistics. Dr. Misa has, however, treated many different health concerns that affect fertility such as PCOS, endometriosis, fibroids, high FSH, absent/irregular periods, low sperm count, poor sperm quality, severe menstrual cramps, and hypothyroidism. What is unique about Dr. Misa s fertility program at Meridian Wellness? First of all, Dr. Misa does not use the negative term infertility with her patients. She prefers to focus positively on their overall well-being, mood and stress management while attempting to optimize female reproductive health. In assessing stress levels, mental health, heavy metal toxicity, and food sensitivities all of which can affect reproductive health, Dr. Misa offers various laboratory tests through hair, urine, saliva and blood. She will spend 90 minutes with you on your first visit to address all your health concerns and questions and obtain necessary information to develop your fertility program. She also offers home visits before and after IVF or IUI treatments so that you can be well-rested and calm during the acupuncture sessions. In addition to acupuncture, Dr. Misa will also incorporate the following modalities in your fertility program: 1. Dietary recommendations to address adequate calorie and balanced nutritional intake, weight loss/gain strategies, and blood sugar regulation (especially in women with PCOS). In Chinese medicine, the energetics of food are also taken into account and will be prescribed by Dr. Misa. For example, women who have cold extremities even in the summer should consume more warming foods such as ginger. 2. Vitamin supplements are important if the patient has vitamin/mineral deficiencies either in the diet or symptoms that come up during the appointment. There are also basic supplements that all women who are trying to conceive should be taking such as folic acid and fish oil. Dr. Misa will prescribe the correct dosages that are appropriate for you.

6 3. Botanical remedies can be used in many aspects of the endocrine/reproductive system including regulating hormones, improve sleep, alleviate PMS symptoms and menstrual cramps, and lower high FSH values. Botanical remedies can also be used to improve detoxification processes in the body by the liver, kidneys, colon, lungs, and skin. 4. Homeopathy is a gentle yet powerful class of natural medicine which can be safely used even during pregnancy. Homeopathic remedies are used at different times of the menstrual cycle to improve the body s function. For example, certain homeopathic remedies can be taken on Day 1, 7, 14 and 21 of the menstrual cycle to guide the body to do its job on during these specific days. 5. Hydrotherapy uses hot and cold water to manipulate the circulatory system to increase blood flow to important areas of the body. It is also an effective technique to improve detoxification processes by the body. 6. Dr. Misa also offers lifestyle techniques to reduce stress, improve sleep and boost energy all important factors in optimal reproductive function. For more information about Dr. Misa, laboratory testing, naturopathic medicine and fertility care, return to our website at